LAPAROSCOPIC CHOLECYSTECTOMY IN DAYSURGERY: ANALYSIS OF FEASIBILITY IN 166 CONSECUTIVE PATIENTS

Abstract

Background: Day-Surgery (DS) is a widely spreading reality, both for clinical advantages to patients and organizational and economic profit to hospitals. In the last years, DS has been proposed for the treatment of a large number of diseases as inguinal and crural hernias, varicose vein, benign anorectal and thyroid pathologies. Recently, also laparoscopic cholecystectomy (LC) has been realised as DS procedure, and the initial results are promising.

Objectives: To determine both the clinical feasibility of LC in DS and the factors that can predict an extension of hospital stay.

Materials and methods: The present study is a retrospective analysis of 166 patients who underwent surgery because of symptomathic cholelithiasis in a three-year period; all patients underwent elective LC in ordinary hospital-stay. In order to identifying the patients potentially eligible for LC in DS, we carried on a selection by means of 3 consecutive stages: stage A, selection on the basis of preoperative data, stage B, selection on the basis of intraoperative factors and stage C, selection on the basis of postoperative parameters.

Results: Out of 166 patients, only 33 (19,8%) would have been successfully treated in DS.

Conclusions. This study showed that LC in DS can be realised in strictly selected patients, on the basis of rigorous clinical and organitational criteria; furthermore, a continuos training of surgeons and nursing staff, the implementation of telemedical facilities and the improvement of anesthesiological techniques will allow to the best results.